Making Sense of OTC Cold and Cough Medications

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Unsure about the hundreds of cold and
flu preparations on the drugstore
shelves? You're not alone. Deciding among the OTC (over-the-counter) remedies for cold,
flu, or allergy symptoms can be intimidating, and a basic
understanding of the types of drugs contained in these medications can help you
make an informed choice.

Decongestants

Decongestants are the drugs of choice for a stuffy,
congested nose. Decongestants act by narrowing the blood vessels in the nose,
leading to decreased blood flow in the nasal tissues and reduced leakage of fluid from the
nose. Decongestants can either be taken orally or applied locally (topically) in
the form of nasal sprays or drops.

Pseudoephedrine (for example, loratadine and pseudoephedrine
[Claritin-D], Sudafed, fexofenadine and pseudoephedrine
[Allegra D]) and phenylephrine are decongestants that can be taken orally. Phenylephrine and oxymetolazone are examples of topical decongestants. While topical decongestants are effective after a few minutes, oral preparations (tablets) can take about
30 minutes to work. Decongestants
act as stimulants that can increase
heart rate, raise the
blood pressure,
exacerbate palpitations, and lead to feelings of nervousness or feeling "hyper."